Friday, June 23, 2017

What is it like to hold the beating heart of a two-day old
child in your hand?What is it like to
counsel distraught parents as they make some of the most difficult decisions of
their lives?

Noted
pediatric heart surgeon Dr. Kristine Guleserian has opened up her OR, and her
career, to author Mark Oristano to create Surgeon’s Story - Inside OR-6 With a top
Pediatric Heart Surgeon.

Dr. Guleserian’s life, training and work are discussed in
detail, framed around the incredibly dramatic story of a heart transplant
operation for a two-year old girl whose own heart was rapidly dying.Author Mark Oristano takes readers inside the
operating room to get a first-hand look at pediatric heart surgeries most
doctors in America
would never attempt.

That’s because Dr. Guleserian is recognized as one of the
top pediatric heart surgeons in America,
one of a very few who have performed a transplant on a one-week old baby. Dr.
Guleserian (Goo-liss-AIR-ee-yan) provided her
expertise, and Oristano furnished his writing skills, to produce A
Surgeon’s Story.

As preparation to write this stirring book, Oristano spent
hours inside the operating room at Children’s Medical Center in Dallas watching
Guleserian perform actual surgeries that each day were life or death
experiences. Readers will be with Dr. Guleserian on her rounds, meeting with
parents, or in the Operating Room for a heart transplant.

Oristano is successful sportscaster and photographer and has
made several appearances on stage as an actor. He wrote his first book A
Sportscaster’s Guide to Watching Football: Decoding America’s Favorite Game, and continues to volunteer at Children’s MedicalCenter.

“We hear a lot about malpractice and failures in medical
care,” says Oristanto, “but I want my readers to know that parts of the
American health care system work brilliantly. And our health care system will
work even better if more young women would enter science and medicine and experience
the type of success Dr. Guleserian has attained.”

Readers will find all the drama, intensity, humor and
compassion that they enjoy in their favorite fictionalized medical TV drama,
but the actual accounts in Surgeon’s Story are even more
compelling. One of the key characters in the book is 2-year-old Rylynn who was
born with an often fatal disorder called Hypoplastic Left Heart Syndrome and
was successfully treated by Dr. Guleserian.

FOR MORE INFORMATION:

The first task is to examine the heart to
see if the preoperative diagnosis is correct. Dr. G uses delicate instruments
to retract portions of the tricuspid valve and examine the extent of the defect
of the ventricular septum, the wall between the two ventricles. She determines
the exact size and shape of the VSD and trims the segment of pericardium she
saved earlier in preservative. She cuts miniscule pieces of the pericardial
tissue and sutures them along the walls of the VSD, creating anchor points for
the actual covering. Each suturing is an intricate dance of fingers and
forceps, needle and thread. Dr. G works with a small, hooked needle, grasping
it with forceps, inserting the needle through the tissue, releasing and
re-gripping with the forceps, pulling the hair-thin suture through, using a
forceps in her other hand to re-grip the needle again and repeat. The
pericardial tissue being sewn over the VSD has to be secure, and it has to
stand up to the pressure of blood pumping through Claudia’s heart at the end of
the operation. This isn’t like repairing knee ligaments, which can rest without
use and heal slowly. Claudia’s heart is going to restart at the end of this
operation, and whatever has been sewn into it has to hold, and work, the first
time. The VSD repair involves cautious work around the tricuspid valve, and
their proximity is a concern because the valve opens and closes along the
ventricular septum with each beat. Dr. G and her team find that it’s preferable
to actually divide the cords of the tricuspid valve to better expose the VSD.
After the patch is fully secured, the tricuspid valve is repaired.

Things
don’t go as smoothly during the attempt to repair the pulmonary valve. When Dr.
G looks inside Claudia’s heart she discovers that the pulmonary valve is not
nearly large enough, and it’s malformed. It only has two flaps where there
should be three. She repairs it by what she later says is “just putting in a
little transannular patch.”

Here’s
what it’s like to “just” put a transannular patch on the pulmonary artery of a
child as small as Claudia:

First,
take a piece of well-cooked elbow macaroni. Tuck it away in a bowl of pasta
that has a bit of residual marinara sauce still floating around in it. Take
several different sized knitting needles. Slowly, without damaging the
macaroni, insert one of the knitting needles into it to see if you can gauge
the width of the macaroni on which you’re operating. Then using a delicate,
incredibly sharp blade, cut a small hole in the piece of elbow macaroni, maybe
a little larger than the height of one of the letters on the page in front of
you. Now use pliers to pick up a small needle with thread as fine as human hair
in it. Use another pliers to pick up a tiny piece of skin that looks like it
was cut from an olive, so thin that light shines through it. Take the needle
and sew the olive skin on to the hole you’ve cut in the piece of macaroni. When
you’re finished sewing, hook up the piece of macaroni to a comparable size tube
coming from the faucet on the kitchen sink, and see if you can run some water
through the macaroni without the patch leaking.

That’s
the food analogy. Those are the dimensions Dr. G worked with as she patched
Claudia’s pulmonary artery. She made it a little wider to give it a chance to
work more efficiently, to transport more blood with less blockage, requiring
less work for the right ventricle so that the built-up heart muscle could
return to a more normal size. It wasn’t the repair she’d planned to make, but
it was the most suitable under the circumstances, and it gave Claudia her best
chance.

Before
restoring Claudia’s natural circulation, the team makes certain that no air is
in the heart or the tubes from the pump, because it could be pumped up to the
brain. Air in the brain is not a safe thing. When all the repairs are
completed, Claudia is rewarmed and weaned from the bypass machine. She was on
pump for 114 minutes and her aorta was clamped for 77 minutes, not an
extraordinary length of time in either case.

Claudia’s
heart starts up on its own, with a strong rhythm. With her heart beating again
the beeps, and the peaks and valleys on her monitor return. All is well. An
echo technician wheels a portable machine into the OR and puts a sensor down
Claudia’s throat where it lodges behind her heart to perform a transesophageal
echo —a more detailed view than the normal, external echo. Everything looks
good. Chest drains are
put in to handle post-operative drainage, and wires are placed for external
pacemakers, should anything go wrong with Claudia’s heart rhythm during her
recovery from surgery. Dr. G draws Claudia’s ribcage back together with
stainless steel wires, perfectly fastened and tightly tucked down.

Claudia
and the surgical team return to the CVICU, and Dr. G monitors her reentry to
the unit, making sure the nurses understand Claudia’s condition and the proper
procedures to be followed for the next 24 hours. From there, Dr. G enters a
small room tucked away from the noise of the unit to meet with the family.
Claudia’s mother, father, and aunt are waiting. Dr. G sees Mom wiping tears
away.

“Are
you crying? Oh, no, no need to be crying, everything is fine.” Her wide smile
reassured Mom, who put away
her tissues.

About the Author

Mark Oristano has been a professional writer/journalist since the age of 16.

After growing up in suburban New York,
Oristano moved to Texas in 1970
to attend Texas Christian
University. A major in Mass
Communications, Mark was hired by WFAA-TV in 1973 as a sports reporter, the
start of a 30-year career covering the NFL and professional sports.

Mark has worked with notable broadcasters including Verne Lundquist, Oprah
Winfrey and as a sportscaster for the Dallas Cowboys Radio Network and Houston
Oilers Radio Network. He has covered Super Bowls and other major sports
events throughout his career. He was part of Ron Chapman’s legendary
morning show on KVIL-FM in Dallas
for nearly 20 years.

In 2002 Oristano left broadcasting to pursue his creative interests,
starting a portrait photography business and becoming involved in theater
including summer productions with Shakespeare Dallas. He follows his daughter
Stacey’s film career who has appeared in such shows as Friday Night Lights and Bunheads.

A veteran stage actor in Dallas, Mark Oristano was writer and performer for
the acclaimed one-man show “And Crown Thy Good: A True Story of 9/11.”

Oristano authored his first book, A Sportscaster’s Guide to Watching Football:
Decoding America’s
Favorite Game.A Sportcaster’s Guide offers inside
tips about how to watch football, including stories from Oristano’s 30-year NFL
career, a look at offense, defense and special teams, and cool things to say during
the game to sound like a real fan.

In 2016 Oristano finished his second book, Surgeon’s Story, a true
story about a surgeon that takes readers inside the operating room during open
heart surgery. His second book is described as a story of dedication, talent,
training, caring, resilience, guts and love.

In 1997, Mark began volunteering at Children’s Medical
Center in Dallas,
working in the day surgery recovery room. It was at Children’s that Mark
got to know Kristine Guleserian, MD, first to discuss baseball, and later, to
learn about the physiology, biology, and mystery of the human heart. That
friendship led to a joint book project, Surgeon’s Story, about Kristine’s
life and career.

ENTER TO WIN!

This is a great book for anyone interested in the medical field. In a society where there are youtube videos for all sorts of surgeries it was nice to have a written book. It is moving and sad at times, and at other times I thought that medicine was a miracle. My hubby recently had surgery and I am glad that I did not read all the inner workings that go on in the operating room. However I would probably have had a more educated conversation with the doctor! I am giving this book a 5/5. I was given a copy, all opinions are my own.